Michelle Lynn Pace, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA24957 Issued in FL

Practice address

13719 Dallas Dr
Hudson, FL 34667-7133

Phone

(727) 862-6795

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1720690795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13719 DALLAS DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13719 DALLAS DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677133",
            "telephone_number": "727-862-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA24957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michelle.pace@live.com",
            "affiliation": "N",
            "address_1": "13719 Dallas Dr",
            "city": "Hudson",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346677133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michelle.pace@live.com",
            "affiliation": "N",
            "address_1": "13719 Dallas Dr",
            "city": "Hudson",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346677133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michelle.pace@live.com",
            "affiliation": "N",
            "address_1": "13719 Dallas Dr",
            "city": "Hudson",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346677133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michelle.pace@live.com",
            "affiliation": "N",
            "address_1": "13719 Dallas Dr",
            "city": "Hudson",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346677133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michelle.pace@live.com",
            "affiliation": "N",
            "address_1": "13719 Dallas Dr",
            "city": "Hudson",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346677133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapy Assistant in Hudson, FL
• Providers in Hudson, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.